BACKGROUND: In the United States, expenditures for prescription drugs are rapidly rising. There is concern that physicians do not prescribe medications in the most cost-saving manner. The objective of this study was to determine if a low-cost administrative intervention would decrease the use of brand name nonsteroidal anti-inflammatory drugs (bnNSAIDs). METHODS: A before-after trial of an administrative intervention to change prescribing behavior at an urban public hospital and its satellite clinics was performed. We evaluated all filled NSAID prescriptions, a total of 127,925, over an 8.5-month period before and after the intervention. The intervention requested physicians to complete a short form listing two generic name nonsteroidal anti-inflammatory drugs (gnNSAIDs) that the patient had already tried if they wished to prescribe a bnNSAID. RESULTS: During the 8.5 months before any intervention, 10.5% of 65,404 NSAID prescriptions were written as brand name prescriptions. For the 8.5 months during the intervention, physicians wrote 62,521 NSAID prescriptions, of which 6.9% (4,322/62,521) were brand name. This represents a 34% decrease in bnNSAID prescriptions (P < 0.0001). Using the average pharmacy acquisition costs for bnNSAIDs and gnNSAIDs, as well as the percentage of decrease in bnNSAID use, we calculated the cost savings to the institution to be $92,914 for the 8.5 months, or a projected annualized savings of $131,172. The decline in bnNSAID prescriptions was site specific; settings in which house staff were supervised by attending physicians had a greater decline when compared to community-based primary care physicians (P < 0.05). CONCLUSION: A low-cost administrative intervention can have a significant impact on physicians' prescribing habits of NSAIDs and result in cost savings to the institution.
%0 Journal Article
%1 Ahluwalia1996
%A Ahluwalia, J S
%A Weisenberger, M L
%A Bernard, A M
%A McNagny, S E
%D 1996
%J Preventive medicine
%K Anti-InflammatoryAgents Chi-SquareDistribution CostSavings CostSavings:methods CostSavings:statistics&numericaldata CostSavings:utilization Drugs Generic Generic:economics Hospitals Humans InterventionStudies Non-Steroidal Non-Steroidal:economics OddsRatio Physician'sPracticePatterns Physician'sPracticePatterns:economics Public Public:economics Public:methods
%N 6
%P 668-72
%R 10.1006/pmed.1996.0105
%T Changing physician prescribing behavior: a low-cost administrative policy that reduced the use of brand name nonsteroidal anti-inflammatory drugs.
%U http://www.ncbi.nlm.nih.gov/pubmed/8936568
%V 25
%X BACKGROUND: In the United States, expenditures for prescription drugs are rapidly rising. There is concern that physicians do not prescribe medications in the most cost-saving manner. The objective of this study was to determine if a low-cost administrative intervention would decrease the use of brand name nonsteroidal anti-inflammatory drugs (bnNSAIDs). METHODS: A before-after trial of an administrative intervention to change prescribing behavior at an urban public hospital and its satellite clinics was performed. We evaluated all filled NSAID prescriptions, a total of 127,925, over an 8.5-month period before and after the intervention. The intervention requested physicians to complete a short form listing two generic name nonsteroidal anti-inflammatory drugs (gnNSAIDs) that the patient had already tried if they wished to prescribe a bnNSAID. RESULTS: During the 8.5 months before any intervention, 10.5% of 65,404 NSAID prescriptions were written as brand name prescriptions. For the 8.5 months during the intervention, physicians wrote 62,521 NSAID prescriptions, of which 6.9% (4,322/62,521) were brand name. This represents a 34% decrease in bnNSAID prescriptions (P < 0.0001). Using the average pharmacy acquisition costs for bnNSAIDs and gnNSAIDs, as well as the percentage of decrease in bnNSAID use, we calculated the cost savings to the institution to be $92,914 for the 8.5 months, or a projected annualized savings of $131,172. The decline in bnNSAID prescriptions was site specific; settings in which house staff were supervised by attending physicians had a greater decline when compared to community-based primary care physicians (P < 0.05). CONCLUSION: A low-cost administrative intervention can have a significant impact on physicians' prescribing habits of NSAIDs and result in cost savings to the institution.
@article{Ahluwalia1996,
abstract = {BACKGROUND: In the United States, expenditures for prescription drugs are rapidly rising. There is concern that physicians do not prescribe medications in the most cost-saving manner. The objective of this study was to determine if a low-cost administrative intervention would decrease the use of brand name nonsteroidal anti-inflammatory drugs (bnNSAIDs). METHODS: A before-after trial of an administrative intervention to change prescribing behavior at an urban public hospital and its satellite clinics was performed. We evaluated all filled NSAID prescriptions, a total of 127,925, over an 8.5-month period before and after the intervention. The intervention requested physicians to complete a short form listing two generic name nonsteroidal anti-inflammatory drugs (gnNSAIDs) that the patient had already tried if they wished to prescribe a bnNSAID. RESULTS: During the 8.5 months before any intervention, 10.5% of 65,404 NSAID prescriptions were written as brand name prescriptions. For the 8.5 months during the intervention, physicians wrote 62,521 NSAID prescriptions, of which 6.9% (4,322/62,521) were brand name. This represents a 34% decrease in bnNSAID prescriptions (P < 0.0001). Using the average pharmacy acquisition costs for bnNSAIDs and gnNSAIDs, as well as the percentage of decrease in bnNSAID use, we calculated the cost savings to the institution to be $92,914 for the 8.5 months, or a projected annualized savings of $131,172. The decline in bnNSAID prescriptions was site specific; settings in which house staff were supervised by attending physicians had a greater decline when compared to community-based primary care physicians (P < 0.05). CONCLUSION: A low-cost administrative intervention can have a significant impact on physicians' prescribing habits of NSAIDs and result in cost savings to the institution.},
added-at = {2023-02-03T11:44:35.000+0100},
author = {Ahluwalia, J S and Weisenberger, M L and Bernard, A M and McNagny, S E},
biburl = {https://www.bibsonomy.org/bibtex/2970d35885343857fc7125065c69a0fcb/jepcastel},
doi = {10.1006/pmed.1996.0105},
interhash = {7ba5514c9691c1b6e643f016688e6474},
intrahash = {970d35885343857fc7125065c69a0fcb},
issn = {0091-7435},
journal = {Preventive medicine},
keywords = {Anti-InflammatoryAgents Chi-SquareDistribution CostSavings CostSavings:methods CostSavings:statistics&numericaldata CostSavings:utilization Drugs Generic Generic:economics Hospitals Humans InterventionStudies Non-Steroidal Non-Steroidal:economics OddsRatio Physician'sPracticePatterns Physician'sPracticePatterns:economics Public Public:economics Public:methods},
note = 2580,
number = 6,
pages = {668-72},
pmid = {8936568},
timestamp = {2023-02-03T11:44:35.000+0100},
title = {Changing physician prescribing behavior: a low-cost administrative policy that reduced the use of brand name nonsteroidal anti-inflammatory drugs.},
url = {http://www.ncbi.nlm.nih.gov/pubmed/8936568},
volume = 25,
year = 1996
}